A Population-Based Study of Breast Cancer-Specific Survival Following Mastectomy and Immediate or Early-Delayed Breast Reconstruction

The Breast Journal, 04/09/2012

The analysis shows that patients who undergo breast reconstruction after mastectomy have a higher breast cancer–specific survival than those undergoing mastectomy alone, when controlling for demographic and oncologic covariates. Further research is required to understand the nature of this relationship.

Methods

  • Population–level de–identified data was abstracted from the SEER database.
  • All female patients treated with mastectomy for a diagnosis of ductal and/or lobular breast cancer between 1998 and 2002 were included.
  • Breast cancer–specific survival was reported as hazard ratios using multivariate analysis to control for patient demographic and oncologic covariates.
  • Demographic covariates included age, race, marital status, income, education, and county metropolitan status; oncologic covariates included tumor stage, histology, grade, lymph node status, hormone receptor status, receipt of radiation therapy, and unilateral or bilateral mastectomy.

Results

  • A total of 52,249 patients were included in the study.
  • Patients treated with mastectomy and reconstruction had a significantly lower hazard of death (HR 0.73, p < 0.0001) compared with patients treated with mastectomy only.
  • Black patients had a significantly increased hazard of death (HR 1.42, p < 0.0001) compared with white patients.
  • Receipt of radiotherapy did not significantly associate with hazard of death (HR 1.03, p = 0.3494).
  • Additionally, bilateral mastectomy did not significantly associate with hazard of death (HR 0.98, p = 0.763).

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